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Relationship between cardiovascular risk factors and high blood pressure by community pharmacists in Spain

Pharmacy World & Science volume 31, pages 406–412 (2009)Cite this article

Abstract

Objectives The aim of this study is to determine the influence that different risk factors (age, gender, obesity, smoking, inactivity, diabetes mellitus and previous diagnosis of arterial hypertension) have on arterial pressure, and to determine the prevalence of patients that have high blood pressure and hypertension but have not received drug-treatment for arterial hypertension. Setting 42 Spanish community pharmacies. Method Observational and descriptive study. Patients included in the study were over 18 years of age, not receiving pharmacological treatment for arterial hypertension and not pregnant. Two measurements of arterial pressure were taken from each patient on the first day of the study and two other measurements on a later day. The average of these four measurements was taken as the arterial pressure value for the patient. All measurements were taken in the participating community pharmacies, always by the pharmacist and following the same protocols. The measurements were noted in the patients’ records along with data about the seven risk factors being studied, allowing them to be related with the patient’s arterial pressure value. Results The number of patients invited to join the study was 3,760, of whom 2,574 agreed to participate, with 2,094 completing the study. It was found that an increase in the number of risk factors led to a corresponding rise in the percentage of patients with high blood pressure and arterial hypertension. The risk of having arterial hypertension was 4.23 times higher in patients aged 65 years and over. It was also 2.88 times greater in those who had been previously diagnosed with arterial hypertension, 2.79 times higher in overweight or obese patients, 2.69 times more in diabetics and 2.22 times higher in men compared with in women. Prevalence of high blood pressure in patients not receiving pharmacological treatment for arterial hypertension was 33.6%, and prevalence of arterial hypertension was 22.8%. Conclusions Of the people studied, 22.8% had arterial hypertension. For the risk factors identified, those most related to the presence of arterial hypertension were, in descending order: being 65 years old or over, previous diagnosis of arterial hypertension, being overweight or obese, being diabetic and being male.

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References

  1. Moser M. Management of hypertension, part I. Am Fam Physician. 1996;53(7):2295–302.

    PubMed  CAS  Google Scholar 

  2. Guidelines Committee. Guidelines for the management of arterial hypertension. The task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87. doi:10.1097/HJH.0b013e3281fc975a.

    Article  Google Scholar 

  3. Guidelines Committee. European society of hypertension––European society of cardiology guidelines for the management of arterial hypertension. J Hypertens. 2003;21(6):1011–53. doi:10.1097/00004872-200306000-00001.

    Article  Google Scholar 

  4. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72. doi:10.1001/jama.289.19.2560.

  5. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The Six Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 6 report. Arch Intern Med. 1997;157:2413–46. doi:10.1001/archinte.157.21.2413.

  6. Guidelines Sub-Committee. World Health Organization (WHO)/International society of hypertension (ISH) statement on management of hypertension. J Hypertens. 2003;21(11):1983–92. doi:10.1097/00004872-200311000-00002.

    Article  Google Scholar 

  7. Williams B, et al. Guidelines for management of hypertension: report of the fourth working party of the British hypertension society, 2004––BHS IV. J Human Hypertens. 2004; 18(3): 139–85.

    Google Scholar 

  8. Marín R, de la Sierra A, Armario P, Campo C, Banegas JR, Gorostidi M. Guía sobre el diagnóstico y tratamiento de la hipertensión arterial en España 2005. Med Clin (Barc). 2005;125(1):36–46. doi:10.1157/13076404. Guidelines on the diagnosis and treatment of arterial hypertension in Spain 2005.

    Article  Google Scholar 

  9. De Backer G, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third joint task force of European and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of eight societies and by invited experts). Eur Heart J. 2003; 24: 1601–10.

    Google Scholar 

  10. Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF, et al. BHS guidelines working party, for the British Hypertension Society. British Hypertension Society guidelines for hypertension management 2004 (BHS-IV): summary. BMJ. 2004; 328: 634–40.

  11. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al. American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Kidney disease as a risk factor for development of cardiovascular disease. A statement from the American Heart Association Councils on Kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention. Circulation. 2003; 108: 2154–69.

    Google Scholar 

  12. American Diabetes Association. Position statement. Hypertension management in adults with diabetes. Diabetes Care. 2004;27(Suppl 1):65–67. doi:10.2337/diacare.27.2007.S65.

    Google Scholar 

  13. Gired X, Mourad JJ, Vaïsse B, Poncelet P, Mallion JM, Herpin D. Estimation du nombre des sujets traités pour une HTA, una diabète ou une hyperlipidémie en France: étude FLASH 2002. Arch Mal Coeur. 2003;96:750–3. Estimation of the number of subjects treated for ATH, diabetes, or hyperlipidemia in France: FLAHS study 2002.

    Google Scholar 

  14. Banegas JR, Rodríguez-Artalejo F, Ruilope LM, Graciani A, Luque M, de la Cruz-Troca JJ, et al. Hypertension magnitude and management in the elderly population of Spain. J Hypertens. 2002;20:2157–64.

    PubMed  Article  CAS  Google Scholar 

  15. Banegas JR, Segura J, Ruilope LM, Luque M, García-Robles R, Campo C, et al. Blood pressure control and physician management of hypertension in hospital hypertension units in Spain. Hypertension. 2004;43:1338–44. doi:10.1161/01.HYP.0000127424.59774.84.

    PubMed  Article  CAS  Google Scholar 

  16. Banegas JR, Rodríguez Artalejo F. El problema de la hipertensión arterial en España. Rev Clin Esp. 2002;202:12–5. The problem of hypertension in Spain.

    Google Scholar 

  17. De la Figuera M, Arnau JM, Brotons C. Hipertensión arterial en Atención Primaria. [Arterial hypertension in primary care]. Badalona: Euromedice; 2002. ISBN 84-931353-0-5.

    Google Scholar 

  18. Whelton PK. Hypertension epidemiology. Lancet. 1994;344:101–6. doi:10.1016/S0140-6736(94)91285-8.

    PubMed  Article  CAS  Google Scholar 

  19. Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D′Agostino RB, Kannel WB, et al. Lifetime risk for developing congestive heart failure The Framingham heart study. Circulation. 2002;106:1–5.

    Article  Google Scholar 

  20. Mataix J, García torres L. Hipertensión arterial. [Arterial hypertension]. En: Mataix J. Nutrición y alimentación humana. [Nutricion and human alimentation]. Madrid: Ergon; 2002. ISBN 84-8473-088-3.

  21. Mayo Nápoles J, Pila Pérez R, Hernández Mandado P, Pila Peláez R, Guerra Rodríguez C. Hipertensión arterial en el joven: factores de riesgo. Rev Med Uruguay. 2000;16:24–30. Arterial hypertension in the young: risk factors.

    Google Scholar 

  22. Zillich AJ, Sutherland JM, Kumbera PA, Carter BL. Hypertension outcomes through blood pressure monitoring and evaluation by pharmacists (HOME study). J Gen Intern Med. 2005;20:1091–6. doi:10.1111/j.1525-1497.2005.0226.x.

    PubMed  Article  Google Scholar 

  23. Machado M, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions part II: systematic review and meta-analysis in hypertension management. Ann Pharmacother. 2007;41(11):1770–81. doi:10.1345/aph.1K311.

    PubMed  Article  Google Scholar 

  24. Oparah AC, Adje DU, Enato EF. Outcomes of pharmaceutical care intervention to hypertensive patients in a Nigerian community pharmacy. Int J Pharm Pract. 2006;14(2):115–22. doi:10.1211/ijpp.14.2.0005.

    Article  Google Scholar 

  25. Mason JD, Colley CA. Effectiveness of an ambulatory care clinical pharmacist: a controlled trial. Ann Pharmacother. 1993;27:555–8.

    PubMed  CAS  Google Scholar 

  26. Lobas NH, Lepinski PW, Abramowitz PW. Effects of pharmaceutical care on medication cost and quality of patient care in an ambulatory-care clinic. Am J Hosp Pharm. 1992;49:1681–8.

    PubMed  CAS  Google Scholar 

  27. Expert Panel on the Identification. Evaluation, and treatment of overweight and obesity in adults. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults; Executive summary. Am J Clin Nutr. 1998;68:899–917.

    Google Scholar 

  28. Consenso SEEDO’2000 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapéutica. Sociedad Española para el Estudio de la Obesidad (SEEDO). Med Clin (Barc). 2000;115:587–97. Consensus SEEDO’2000 for the evaluation of overweight and obese people, and the establishment of therapeutic intervention. Spanish Society for the Study of Obesity (SEEDO).

  29. McAlister FA, Straus SE. Evidence based treatment of hypertension: measurement of blood pressure an evidence based review. BMJ. 2001;322:908–11. doi:10.1136/bmj.322.7291.908.

    PubMed  Article  CAS  Google Scholar 

  30. O’Brien E, Waeber B, Parati G, Staessen J, Myers MG. Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ. 2001;322:531–6. doi:10.1136/bmj.322.7285.531.

    PubMed  Article  Google Scholar 

  31. Martínez Pérez SR, Sánchez Alonso FJ, Baena Parejo MI. Efectos de la intervención farmacéutica en pacientes con presión arterial elevada sin tratamiento farmacológico. Seguim Farmacoter. 2004;2(3):181–8. Effects of pharmaceutical intervention in patients with high blood pressure without pharmacological treatment.

    Google Scholar 

  32. Carrión Valero L, Carballo Herencia JA, Divisón Garrote JA, Massó Orozco J, Artigao Rodenas LM, Sanchís Domenech C, et al. La oficina de farmacia puede mejorar el grado de conocimiento de la hipertensión arterial. Hipertension. 2002;19(7):299–304. Community pharmacies could improve awareness on arterial hypertension.

    Google Scholar 

  33. Velázquez MO, Lara EA, Martínez MMY, Márquez FF. La detección integrada como un instrumento para vincular la prevención primaria, el tratamiento temprano y la vigilancia epidemiológica en diabetes e hipertensión arterial. Rev Endocrinol Nutr. 2000;8(4):129–35. Detection integrated as an instrument linked to primary care, early treatment and epidemiological vigilance in diabetes and arterial hypertension.

    Google Scholar 

  34. Martínez Pérez SR, Sánchez Alonso FJ. Determinación de factores de riesgo en pacientes con diferentes valores de presión arterial. Pharm Care Esp. 2006;8(5):200–8. Determination of risk factors en patients with different values of arterial pressure.

    Google Scholar 

  35. Erthun WO, Agbani EO, Bolaji EE. Positive benefits of a pharmacist-managed hypertension clinic in Nigeria. Public Health. 2005;119(9):792–8. doi:10.1016/j.puhe.2004.11.009.

    Article  Google Scholar 

  36. Hourihan F, Krass I, Chen T. Rural community pharmacy: a feasible site for a health promotion and screening service for cardiovascular risk factors. Aust J Rural Health. 2003;11(1):28–35. doi:10.1046/j.1440-1584.2003.00468.x.

    PubMed  Article  Google Scholar 

  37. Carter BL, Elliot WJ. Role of pharmacist in the detection, management, and control of hypertension: national call to action. Pharmacotherapy. 2000;20(2):119–22. doi:10.1592/phco.20.3.119.34778.

    PubMed  Article  CAS  Google Scholar 

  38. Borenstein JE, Graber G, Saltiel E, Wallace J, Ryu S, Archi J, et al. Physician-pharmacist comanagement of hypertension: a randomized, comparative trial. Pharmacotherapy. 2003;23(2):209–16. doi:10.1592/phco.23.2.209.32096.

    PubMed  Article  Google Scholar 

  39. Zillich AJ, Milchak JL, Carter BL, Doucette WR. Utility of a questionnaire to measure physician-pharmacist collaborative relationships. J Am Pharm Assoc. 2006;46(4):453–8. doi:10.1331/154434506778073592.

    Article  Google Scholar 

  40. Park JJ, Nelly P, Carter BL, Burgess PP. Comprehensive pharmaceutical care in the chain setting: drug therapy monitoring and counselling by pharmacists contributed to improved blood pressure control in study patients. J Am Pharm Assoc. 1996;36:443–51.

    Google Scholar 

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Acknowledgements

The authors are grateful to the community pharmacists at the 43 Spanish pharmacies who participated in this study and would also like to thank the communication media (magazines and periodicals), official colleges of pharmacists, pharmaceutical cooperatives and professional associations of pharmacists that collaborated in publishing this study and provided free use of their facilities. The authors would also like to thank Mr. Daniel Ross for revision of the manuscript.

Funding

The authors declare that no funding of any kind has been received for this study.

Conflicts of interests

The authors declare no conflicts of interest or financial interest in any product or service mentioned in this article.

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Affiliations

  1. Farmacia Ldo. Sebastián R. Martínez Pérez, Carretera de Jaén nº 5, Código Postal 18014, Granada, España

    Sebastián R. Martínez Pérez & Andrea C. Molina Guerra

  2. Pharmacology Department, Faculty of Chemical Sciences, National University of Córdoba, Haya de la Torre y Medina Allende s/n, Ciudad Universitaria, Córdoba, Argentina

    Pedro D. Armando

  3. Pharmaceutical Care Foundation of Spain, C/Rosellón 331-333, entlo 2ª 08037 Barcelona, España

    Mercé Martí Pallarés

  4. Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, Granada, España

    Fernando Martínez Martínez

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  1. Sebastián R. Martínez Pérez
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  2. Pedro D. Armando
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Correspondence to Sebastián R. Martínez Pérez.

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R. Martínez Pérez, S., D. Armando, P., C. Molina Guerra, A. et al. Relationship between cardiovascular risk factors and high blood pressure by community pharmacists in Spain. Pharm World Sci 31, 406–412 (2009). https://doi.org/10.1007/s11096-008-9267-7

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  • DOI: https://doi.org/10.1007/s11096-008-9267-7

Keywords

  • Age
  • Community pharmacy
  • Diabetes
  • Gender
  • Hypertension
  • Obesity
  • Prevalence
  • Risk factor
  • Spain